Causes

Urine normally flows from the kidneys. It passes through tubes called ureters and into the bladder. Each ureter connects to the bladder in a way that prevents the backflow of urine. The connection is similar to a one-way valve. When the valve does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up the ureter and into the kidney.

Most VUR results from residual, undected childhood disease, but may have other causes. Some examples include:

Symptoms

Generally, VUR has no symptoms and can remain undetected into adulthood. In some, it is found after a
urinary tract
or
kidney infection
is diagnosed and evaluated. Flank pain may be present during the time the bladder is filling with urine.

Complications of undetected or untreated VUR include:

Problems with normal kidney function—scarring from backed-up urine causes damage to structures in the urinary tract, including the kidneys

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may suspect VUR based on your history. Many times VUR is found incidentally during testing for another problem, such as high blood pressure, kidney stones, neurogenic bladder, other urinary problems, or abdominal pain.

If your doctor suspects VUR, a voiding cystourethrogram (VCUG) is usually done. VCUG is an imaging test that evaluates structures during urination. Other tests may include:

Treatment

VUR in adults does not usually resolve over time. The goal for treatment of VUR is to reduce or stop the back up, and prevent additional and permanent damage. Treatment depends on the severity of VUR and may include one or more of the following options:

Surgery

Surgery may be done for more severe VUR or in cases when other treatment methods fail. Procedures include:

Endoscopic injection into the ureter—Material is injected where the ureter inserts into the bladder. This can prevent urine from going back up into the ureter. It is done during a procedure called a
cystoscopy.

Ureteral reimplantation—Repositions the ureters in the bladder. It can be done as an open or laparoscopic procedure.

Prevention

To help reduce your chances of VUR:

Seek prompt treatment for any urinary problems, including a bladder or kidney infection.

If you are pregnant, go to any recommended prenatal screenings as advised by your doctor.

If you are prone to frequent urinary tract or kidney infections, ask your doctor about prophylactic antibiotics to prevent infection.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.